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Researchers at Ohio State’s Neurological Institute studied 10 patients who were living with severe chronic leg pain and had spinal-cord stimulators implanted to reduce their pain. The study is based on findings that propose a neuromatrix of pain, in which pain perception varies according to cognitive, emotional and sensory influences.

Using functional magnetic resonance imaging (fMRI), researchers isolated and mapped the areas of the brain involved in pain perception and modulation. This information was used to detect changes in neural networks and processing.

The default mode network (DMN), the resting state network of the brain, is responsible for cognitive and emotional aspects of pain; as such, the DMN was used as the comparison basis for changes in neural connectivity during stimulator-induced pain relief.

The fMRIs of the patients indicated which areas of the brain increased or decreased connectivity during spinal-cord stimulation. An analysis of brain activity showed that spinal-cord stimulation decreased the affective component of pain in the neural networks connecting sensory and emotional factors.

Understanding how these neural networks interact is key to developing new therapies to manage chronic pain, according to first author Dr. Milind Deogaonkar, an Ohio State neurosurgeon who specializes in neuromodulation.

“Our initial study provides insights into the role of the brain’s emotional networks in relieving chronic pain,” says principal investigator Dr. Ali Rezai, director of the Center for Neuromodulation, in a press release. “We are the first to show that therapeutic spinal-cord stimulation can reduce the emotional connectivity and processing in certain areas of the brain in those with chronic pain. Being able to modulate the connections between the brain areas involved in emotions and those linked to sensations may be an important mechanism involved in pain relief linked to spinal-cord stimulation.”

Other Ohio State researchers involved in the study are Mayur Sharma, Dylan Nielson, Xiangyu, Louis Vera-Portocarrero, Gregory F. Molnar, Amin Abduljalil, Per Sederberg and Michael Knopp. Chima Oluigbo of the Children’s National Medical Center in Washington is also involved in the study.

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